Summary
The syndrome of inappropriate secretion of antidiuretic hormone is a rare but well-recognized neurotoxic side effect of vincristine therapy. The first neuropathological report of a case is presented. A 6-month-old boy with skin leukemia developed inappropriate secretion of antidiuretic hormone caused by vincristine. Postmortem examination revealed axonal spheroids in the ansa lenticularis and the area surrounded by the substantia innominata, amygdala and supraoptic nucleus. The lesion was confined to that area and the neurosecretory neurons were intact with well preserved neurophysin. The pathological findings suggest that these fibers play a role in the development of inappropriate secretion of antidiuretic hormone caused by vincristine therapy.
Zusammenfassung
Das Syndrome der ungenügenden Sekretion des antidiuretischen Hormones ist eine zwar bereits beschriebene, aber seltene Nebenwirkung einer Vincristine-Therapie. Es wird der erste neuropathologisch untersuchte Fall vorgestellt. Bei einem sechs Monate alten Knaben mit einer Leukämie der Haut trat nach Vincristine-Therapie eine Störung der Sekretion des antidiuretischen Hormons auf. Die histologische Untersuchung ergab spheroide Veränderungen der Axone im Bereiche der Ansa lenticularis und im Bereiche der Substantia innominata, der Amygdala und des Nucleus supraopticus. Die Veränderungen beschränkten sich auf die erwähnten Bezirke, während die neurosekretorischen Neurone unauffällig erschienen mit gut erhaltenem Neurophysin. Die neuropathologischen Befunde legen die Annahme nahe, daß die erwähnten Fasern eine Rolle bei der Entstehung der Störung der Sekretion des antidiuretischen Hormons bei Vincristine-Therapie spielen.
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Tomiwa, K., Mikawa, H., Hazama, F. et al. Syndrome of inappropriate secretion of antidiuretic hormone caused by vincristine therapy: a case report of the neuropathology. J Neurol 229, 267–272 (1983). https://doi.org/10.1007/BF00313556
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DOI: https://doi.org/10.1007/BF00313556